Breakthroughs in medicine

(Part III of “Man owes his life to inventors of the past 20 centuries.”)

In the late 19th century, many doctors admitted that nature, when left to its own devices, was far more effective than medicine. Only in the 20th century, as medical science entered an age of achievement, did research into the root causes of diseases lead to its better understanding; and new machines allowed doctors to record what was happening inside the body.

Machines that captured the image of the human bones, heart, brain and fetus

For most of human history, the accurate diagnosis of disease had been impossible. The ancient techniques of physical examination were merely feeling, listening, tapping and pressing. In the 17th century, doctors began to use pendulums and thermometers. It was only in the 20th century that technology made possible a deeper level of understanding of the illnesses that beset mankind.

Some of the most influential diagnostic devices came by chance discovery made in 1895 by a German professor of physics, Wilhelm Roentgen. One evening, while tinkering in a laboratory with a cathode-ray tube and fluorescent screen, he discovered how to produce a new type of radiation, which could be used to view human bones. He called them “X-rays”, the ‘X’ meaning unknown.

Within the next half a century, X-rays were used to photograph just about anything in the human body. Then, it became clear that X-rays could cause cancer. So with additional research, the negative effect of radiation was put to positive use through its new form known as radiotherapy.

X-ray, however, could not monitor the heart accurately because it consists of soft tissue only. The first major breakthrough came in 1903, when the Dutch psychologist Willem Einthoven invented a ‘string galvanometer’ to record the electrical impulses produced by the heart. It worked by carrying the feeble electrical impulses in the arms and legs to a quartz fiber, the string set in a magnetic field. Its movements were captured on a moving glass photographic plate. His 600lb (270 kg) machine revealed that each heartbeat produces five main electrical pulses, helping make a detailed portrait of the heart and pinpointing any irregularity. This machine was the prototype of today’s electrocardiograph. With Horace Darwin, younger son of Charles, Einthoven produced a portable version that recorded the data on paper.

Electricity was also the basis for a new means of understanding the brain as pioneered by the German psychologist Hans Berger. In 1929, he invented the electroencephalograph (EEG) device. Tracing out a minute the shaky impulses produced by the brain as recorded from electrodes in the skull, the EEG revealed that the normal brain has several distinct states – excited, relaxed, drowsy, dreaming asleep, deeply asleep, in coma –, and that the waves were produced by different areas of the brain. Moreover, different people have different patterns of brainwaves. Once these variations were understood, the EEG proved invaluable in diagnosis.

The new awareness of limiting X-rays, especially on pregnant women, led to the discovery of Ultra Sound Scan that used the sound-echo of the World War II machine utilized to detect submarines. In the late 1950s it struck Ian Donald, a professor of Midwifery at Glasgow University, that if sonar could tell the position and shape of a submarine, it could also “see” a fetus.

With computer enhancement that turned the echoes into visual images, the technique became a routine way to monitor all aspects of pregnancy. Innumerable women have now had the extraordinary experience of seeing a blurry image of their unborn child on an ultrasound scan.

Wonder drugs

The 20th century was the age of the ‘magic bullet,’ a phrase coined by chemotherapy’s founder Paul Ehrlich to refer to drugs designed precisely to cure diseases.

The story of how Scottish bacteriologist Alexander Fleming discovered the antibiotic penicillin in his untidy little laboratory has assumed the status of modern myth — with its mixture of chance, hard work, frustration, and finally, success. He revealed his findings publicly in 1929, but the world had to wait until 1941 when the Oxford research team of Howard Florey and Ernst Chain appealed to America’s Department of Agriculture to help produce the drug in time to treat Allied troops dying of infections at the warfront.

As the work on penicillin progressed, scientists were also researching other antibiotics, both natural and artificial. The first group sulphonamides drastically reduced meningitis deaths from 65 percent to 20 percent. In 1948, streptomycin, derived from a type of bacteria, marked the beginning of the end of tuberculosis.

Another area of research focused on viruses, a class of disease-causing organisms implicated in everything from yellow fever to the common cold. The most significant was the one that conquered poliomyelitis (polio).

In 1939, President Roosevelt himself a polio victim, had established the National Foundation for Infantile Paralysis (NFIP) to fund research and its cure. By 1954, the NFIP was testing a vaccine on 1.8 million children, the largest clinical trial in history. The NFIP’s vaccine developed by Jonas Salk was not completely effective against all three forms of polio and the treatment was in the form of injections with up to eight boosters. These was resolved by Russian-born virologist Albert Sabin, whose more effective, faster-acting ‘live’ vaccine could be taken orally. The result was the vaccine in a cube of sugar that became familiar to literally millions of children over the last 30 years.

The invention of the pill

In the 1950s, American Gregory Pincus developed the first contraceptive pill. His work was a progression from earlier findings that wild yams in Mexico yield a substance that can be transformed into the female sex hormone, progesterone. Once Pincus had established a modified form of progesterone that inhibited ovulation, the stage was set.

A campaign by feminist and birth-control crusader Margaret Sanger brought Pincus a $115,000 research grant. The end product, norethynodrel, went on sale in 1960. Since that time, the Pill has been refined to reduce the risk of side effects such as an increased risk of thrombosis leading to heart attacks and strokes. Overall, the risks were small but enough to introduce various modifications (particularly in the 1970s), as well as other alternatives. The 1980s saw the introduction of injectable hormonal contraceptives, as well as the PC4 post-coital pill. Often known as the “morning after pill”, the PC4 is actually effective three days after unprotected sex. In 1986, the RU486 or abortive pill became available as an alternative to surgical termination in France (where it was invented).

The latest research is concentrated on the much-awaited male contraceptive pill, which is being tested in the United States and France. Thanks to the Pill, women acquire near-total control over their own fertility. But what a growing minority of women wanted was medical help in controlling their lack of fertility. During the late 1960s and 1970s, the combination of microsurgery, ultrasound, endoscopy and new drugs allowed doctors to examine, stimulate, remove and replace as never before.

Among the best-known development was in vitro – in glass – fertilization (IVF) developed in England by Dr. Patrick Steptoe and Dr. Robert Edwards. This method involved a number of new, interrelated techniques that culminates in the scientific fertilization of one or more embryos outside the body that is then replaced back into the womb.

IVF opened up more high-tech possibilities like the Gamete Intrafallopian Transfer (GIFT), in which gametes or eggs and sperm are placed into the Fallopian tube. Other options include egg donation, embryo donation and surrogate motherhood.

The major medical discoveries dominated the 20th century

The 20th century allowed doctors to understand the various ailments of the human body and find their cure. The people of the 21st century are now the most fortunate being the beneficiaries of this treasure of discoveries of men gifted with visions to prolong life.

1902 – Queen Alexandra wore the first electrical hearing aid during the coronation of King Edward VII; 1910 – Paul Ehrlich, a German medical pioneer discovered the cure for syphilis; 1914 – Basic experiments in renal dialysis in Boston, USA; 1929 – Werner Forssman invents the cardiac catheter in Germany; 1938 – The first practical contact lenses was developed. 1943 – Willem Kolff (Netherland) invents the dialysis machine. 1944 – Sir Ludwig Guttman sets up a spinal injuries center at Stake Mandeville, UK. Later the Patient Operated Selector Mechanism (Possum) was invented;1945 – Fleming, Chain and Florey shares the Nobel Prize for the discovery of penicillin.

1952 – Charles Hufnagel (USA) implants artificial heart valve; 1953 – James Watson and Francis Crick win the Nobel Prize for the discovery of how the human genetic code works (DNA); 1954 – First kidney transplant in Boston, USA; 1960 – First plastic hip replacement by John Charnley; the first oral contraceptive went on sale; 1964 – First human heart transplant by Dr. Christian Barnard of South Africa; 1978 – Birth of Louise Brown, the first so-called “test-tube baby” in UK; 1982 – Insulin produced by genetic engineering used to treat diabetes. 1988 – A man was fitted a plutonium power-sourced pacemaker. 1995 – Computer-aided design and manufacture of artificial limbs went into service in Vietnam.

These series of scientific discoveries continue to be engineered to perfection, revolutionizing our lives within the century.

Reference: The Eventful 20th Century by Reader’s Digest

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